Chuna Manual Therapy for Constipation Predominant Irritable Bowel Syndrome: Systematic Review and Meta-analysis

Objectives : This review aimed to evaluate the effect and clinical utilization of chuna manual therapy (CMT) for constipation predominant irritable bowel syndrome. Methods : Literature search was conducted using 12 electronic databases: PubMed, EMBASE, The Cochrane Library, Ovid, Web of Science, Chinese Academic Journals, KMBASE, ScienceOn, Korea Med, OASIS, KISS, and RISS. Only randomized controlled trials (RCTs) using CMT for constipation predominant irritable bowel syndrome treatment were included. The risk of bias of each RCT was evaluated using the Cochrane risk of bias tool. Results : Seven RCTs met the inclusion criteria. CMT alone and CMT combined with Western medication showed positive result on constipation predominant irritable bowel syndrome treatment. Two RCTs that compared CMT alone with placebo medicine showed partially positive results in meta-analysis. However, vasoactive intestinal peptide and cholecystokinin values of these studies were evaluated in an opposite way; thus, meta-analysis of these values were not conducted. Conclusions : CMT may be effective and clinically utilizable for constipation predominant irritable bowel syndrome treatment. However, there is limited evidence due to lack of well-designed RCTs. Further well-designed RCTs are needed for stronger evidence.